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MR. TIMOTHY RAY BEVERLY CDCA
NPI 1194211409
Counselor - Addiction (Substance Use Disorder) in Fairborn, OH

Active since July 10, 2018
302 W MAIN ST, FAIRBORN, OH 45324(937) 281-4673 Get Directions Write a Review

NPPES record last updated: January 25, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 22, 2020, Jul 10, 2018 (2 updates tracked since 2018).

About Mr. Timothy Ray Beverly Cdca NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. TIMOTHY RAY BEVERLY CDCA (NPI 1194211409) is an individual addiction (substance use disorder) provider in Fairborn, Ohio, licensed in Ohio (LCDCII.161829) and active in the NPI registry since July 2018.

NPPES Registry Identity

NPI1194211409
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. TIMOTHY RAY BEVERLYCredential: CDCA
Location Address302 W MAIN STFairborn, OH 45324-5037
Mailing Address100 Crowne Point PlaceCincinnati, OH 45241-5427 · (513) 743-7628
Phone(937) 281-4673
Sole ProprietorNo
Enumeration DateJuly 10, 2018
Last NPPES UpdateJanuary 25, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 25, 2024
✔ NPI 1194211409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
Licenses✔ Licensed in OH · LCDCII.161829✔ Licensed in OH · 070488
302 W MAIN ST, Fairborn, OH 45324
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGAN N RIDER CDCA
Counselor (Addiction (Substance Use Disorder))
302 W MAIN ST
FAIRBORN, OH 45324
Greene County (937) 281-4673
HAILEY CIERRA KEMP CDCA
Counselor (Addiction (Substance Use Disorder))
302 W MAIN ST
FAIRBORN, OH 45324
Greene County (937) 281-4673
LAURA A RODGERS
Social Worker
302 W MAIN ST
FAIRBORN, OH 45324
Greene County (937) 281-4673
MS. CONNIE S WILLIAMS LISW-SUPV
Social Worker (Clinical)
302 W MAIN ST
FAIRBORN, OH 45324
Greene County (937) 281-4673
MELISSA MURRELL
Counselor (Addiction (Substance Use Disorder))
302 W MAIN ST
FAIRBORN, OH 45324
Greene County (937) 281-4673
CYNTHIA DARDEN
Social Worker
302 W MAIN ST
FAIRBORN, OH 45324
Greene County (937) 281-4673
MICHAEL I LETTS LCDCII
Counselor (Addiction (Substance Use Disorder))
302 W MAIN ST
FAIRBORN, OH 45324
Greene County (937) 281-4673
NAMYA WRIGHT
Case Manager/Care Coordinator
302 W MAIN ST
FAIRBORN, OH 45324
Greene County (937) 281-4673

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Beverly's NPI number?

The NPI number for Timothy Beverly is 1194211409. It was assigned to this individual provider in the NPPES registry on July 10, 2018.

Where is Timothy Beverly located?

Timothy Beverly practices at 302 W Main St, Fairborn, OH 45324. The listed phone number is (937) 281-4673.

What is Timothy Beverly's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Timothy Beverly was last updated on January 25, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.